Provider Demographics
NPI:1972638005
Name:LINCOLN, LISA ANN (LCSW)
Entity type:Individual
Prefix:MS
First Name:LISA
Middle Name:ANN
Last Name:LINCOLN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1012 SAINT LOUIS ST
Mailing Address - Street 2:
Mailing Address - City:SCOTT
Mailing Address - State:LA
Mailing Address - Zip Code:70583-5116
Mailing Address - Country:US
Mailing Address - Phone:337-303-2680
Mailing Address - Fax:
Practice Address - Street 1:119 RUE FOUNTAINE
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508-5744
Practice Address - Country:US
Practice Address - Phone:337-984-8355
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA61371041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical